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ObjectiveTo conduct comprehensive assessment of internal and external cadmium exposure and health risks for Shanghai residents. MethodsCadmium levels in food samples were calculated by employing two dietary exposure assessment methods, total diet study (TDS) and food frequency questionnaire (FFQ), to estimate the daily dietary cadmium exposure of Shanghai residents. The provisional tolerable monthly intake (PTMI) of cadmium set by joint food and agriculture organization/WHO expert committee on food additives (JECFA) was applied to evaluate the health risk. Differences in dietary and urinary cadmium were compared by rank-sum test among different regions, age, gender, smoking status, and BMI groups, and the association between internal and external cadmium exposure was investigated by correlation analysis. ResultsThe mean value of urinary cadmium for 1 300 respondents was 0.542 μg·L-1. Urinary cadmium was higher in the population in central urban and urban-rural fringe areas than in the suburban area, higher in the older age group than in the younger age group, and higher in the smoking group than in the non-smoking group (all P<0.01). The two assessment methods showed that the mean values of daily dietary cadmium exposure for Shanghai residents were 0.306 and 0.090 μg·kg-1, with 3.69% and 0.85% of Shanghai residents exceeding the PTMI, respectively. Correlation analyses showed that dietary exposure to cadmium based on the FFQ method was positively correlated with the urinary cadmium level when smoking status, age, gender, and BMI were adjusted. ConclusionDietary exposure to cadmium of Shanghai residents is mainly derived from vegetables, aquatic products, cereals and potatoes, and is overall at a low-risk level. Dietary exposure assessment based on FFQ and risk monitoring data can effectively estimate long-term cadmium exposure.
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Background Children and adolescents drink sugar-sweetened beverages (SSBs) frequently. Research has confirmed that SSBs associate with weight gain and overweight or obesity. However, it is unclear whether high SSBs intake associates with abnormal changes in physical growth and glucolipid metabolism before causing adverse health outcomes such as overweight and obesity. Early identification of associated health risks of overconsumption of SSBs have important public health implications. Objective To investigate the differences in physical growth and glucolipid metabolism between different SSBs intake frequency groups in normal weight children and adolescents aged 6-17 years, and to evaluate the early effects of SSBs intake on physical growth and glycolipid metabolism before causing overweight and obesity, aiming to provide a scientific basis for the prevention and control of childhood overweight and obesity and related chronic diseases, and for the formulation of policies on the control of SSBs consumption. Methods Data were from the Shanghai Diet and Health Survey (SDHS) among primary and secondary school students. The participants were normal weight children and adolescents aged 6-17 years. Propensity scores were calculated according to energy intake and physical activity factors, after stratifying by age and gender. Participants were 1:1 matched with the closest propensity scores in the high-frequency (≥1 time·d−1) and the low-frequency (≤1 time·week−1) SSBs intake groups. The outcome indicators were physical measurements such as height, weight, percent of body fat, and waist circumference, and metabolic indicators such as fasting blood glucose, total triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Body mass index (BMI) was calculated. Food frequency questionnaire was used to collect SSBs consumption in the past three months through face-to-face interview. A paired t-test was used to compare the differences in physical and glycolipid metabolic indicators between the high-frequency intake group and the low-frequency intake group of SSBs. Results A total of 431 pairs were obtained. For children and adolescents in grades 6-9, overall height (difference=2.92 cm, P=0.002), weight (difference=2.53 kg, P=0.003), and waist circumference (difference=1.34 cm, P=0.035) were higher in those who consumed SSBs ≥1 time·d−1 than in those who consumed ≤1 time·week−1. For children and adolescents in grades 10-12, overall weight (difference=2.27 kg, P=0.041) was higher in those who consumed SSBs ≥1 time·d−1 than in those who consumed ≤1 time·week−1. Over 95% of the study subjects reported blood glucose and lipid test results within the normal range; but girls in grades 1-5 who consumed SSBs ≥1 time·d−1 had a higher total cholesterol (difference=0.20 mmol·L−1, P=0.027) and low-density lipoprotein cholesterol (difference=0.19 mmol·L−1, P=0.010) than those who consumed ≤1 time·week−1; boys in grades 6-9 who consumed SSBs ≥1 time·d−1 had a lower high-density lipoprotein cholesterol (difference=-0.10 mmol·L−1, P=0.039) than those who consumed ≤1 time·week−1. Conclusion High-frequency intake of SSBs may be associated with higher total cholesterol and low-density lipoprotein cholesterol in normal weight children and adolescents in grades 1-5, and higher weight in normal weight children and adolescents in grades 6-12. There is an urgent need to educate children and adolescents about nutritional health, enhance their ability to make healthy food and beverage choices, and take early interventions to control the intake of SSBs in children.
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Diabetes is a complex disease caused by the combined effects of genetic and environmental factors, which seriously affects people’s health level and living quality. As a special research tool, the twin method can be used to estimate the relative effects of genes and environment on diabetes-related traits. Moreover, compared with regular study subjects, twins have natural controls. The extended methods combined with genetic statistics and molecular biology techniques also help to analyze risk factors of diabetes and clarify the true relationship between exposure and outcome. This paper reviewed the progress of the application of the twin method to diabetes factorial studies in the past ten years at home and abroad, and summarized the advantages and limitations of the classical twin model, co-twin control studies, and genome-wide and epigenetic epidemiological studies.
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ObjectiveTo provide basic data of daily dietary intake from various food categories as well as in different regions, seasons, genders, and age groups in Shanghai residents aged 15 and over. MethodsMultistage stratified proportional probability sampling (PPS) was used to extract the samples, and food frequency questionnaire (FFQ) was used to investigate the dietary intake of the subjects in four seasons from 2012 to 2013. The weighted statistical analysis of the samples comprehensively considered the sampling design weights, the stratified adjustment weights, and the non-response adjustment weights. ResultsThe total daily dietary intake (excluding drinking water) of residents aged 15 years and above was 1 174.71 g, and the highest three daily dietary intake categories were cereals (252.31 g), vegetables (205.36 g) and fruits (141.00 g). The total daily dietary intake of the residents in the urban area, the suburban area and the rural area was 1 209.15 g,1 172.27 g and 948.50 g, respectively, and the total daily dietary intake in the outer suburb area was significantly lower than that in other areas (F=74.12,P<0.001). The total daily dietary intake in different seasons was 1 232.47 g in spring, 1 166.80 g in summer, 1 241.15 g in autumn and 1 088.83 g in winter, respectively. The total daily dietary intake in winter was lower than that in other seasons (F=15.96,P<0.001). Fruits and beverages intake showed apparent seasonality. The total daily dietary intake in male and female residents was 1 234.03 g and 1 112.32 g, respectively, and the total daily dietary intake of male was higher than that of female (F=78.59,P<0.001). The total daily dietary intake of residents in different age groups was 1 218.64 g for 15‒44 years old, 1 141.27 g for 45‒59 years old, and 1 064.54 g for 60 years old and above (F=20.28,P<0.001). ConclusionThe daily intake of cereals, livestock and poultry meat, aquatic products, eggs and edible oil is relatively balanced, but the daily intake of vegetables, fruits and milk is relatively insufficient for the residents aged 15 years and above in Shanghai. The daily intake of different food types shows distinguishable characteristics in urban and rural areas, seasons, age groups and genders.
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Peutz-Jeghers syndrome (PJS) presents in early childhood, and children have a higher risk of intussusception due to a smaller abdominal space than adults. Double-balloon enteroscopy (DBE) has been proven to be a safe and effective method for the diagnosis and treatment of small bowel lesions, but the efficacy and safety of its prophylactic polypectomy in children with PJS need to be determined. Data of 6 children (median age 10.6 years) diagnosed as having PJS from 2018 to 2020 were reviewed. DBE was performed 14 times, and 3 children were successfully relieved of intussusception after DBE treatment. The sizes of the resected intussusception polyps were 50 mm×60 mm, 40 mm×35 mm, and 50 mm×40 mm. Symptoms associated with polyps (abdominal pain, intussusception and obstruction) relieved after DBE in all children. No direct complications such as bleeding or perforation were found during the operation, and no recurrence of intussusception was found during follow-up. It can be seen that DBE polypectomy is safe and effective in the treatment of intussusception caused by PJS.
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ObjectiveTo determine the situation and challenges of innovation platforms in China, and to explore the construction strategy of Shanghai Nutrition Innovation Platform, which is suitable for Shanghai and may achieve the research and transformation of nutrition innovation and population health, so as to coordinate, unite and gather the superior resources of all parties and promote nutrition innovation. MethodsConstruction scheme and operational mechanism of Shanghai Nutrition Innovation Platform were explored by literature review, expert consultation and questionnaire. ResultsThere were various forms of innovation platforms in China. However, challenges were identified, such as decentralizing force, resource rearrangement and insufficient sharing effect. Shanghai Nutrition Innovation Platform adopted a modular organizational structure, which was divided into central group, node group, and subject group. Shanghai Center for Disease Control and Prevention, as the central organization, is responsible for the platform operation management. The expert database as an academic committee selected key organizations from nutrition-related universities, research institutes, academic associations, centers for disease control and prevention, hospitals and the industry. Based on the opening of its own innovation resources, the platform made effective use of external innovation resources and formed a closely integrated nutrition innovation network of multiple disciplines. ConclusionThis study promotes the construction of innovation platform model of cooperation, co-construction and resource sharing, and provides reference for the construction of innovation platform in China.
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Objective@#To evaluate the efficacy and safety of compound Lactobacillus acidophilus tablets or Saccharomyces boulardii Sachets combined with standard protocols for eradication of Helicobacter pylori(Hp) in children.@*Methods@#From March 2017 to March 2018, 120 children aged 3-10 years with Hp infection were admitted into the Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, including 67 male and 53 female childen.They were divided into 3 groups (control group, compound Lactobacillus acidophilus group, Saccharomyces boulardii Sachets group) by the method of random number table.Control group was given Clarithromycin+ Amoxicillin+ Omeprazole, for 14 days orally; compound Lactobacillus acidophilus group and Saccharomyces boulardii Sachets group were given drugs respectively on the first day, 500 mg of compound Lactobacillus acidophilus was added, twice a day or 250 mg of Saccharomyces boulardii Sachets group, twice a day orally, for 14 days, respectively.The adverse reactions in children were observed during the treatment, andurea 13C breath test or the stool Hp antigen test was performed at least 4 weeks by the end of the treatment, and the children with negative results were judged to be eradicated successfully.The ulcer healing, Hp eradication rate and incidence of adverse reactions(nausesa, vomiting, loss of appetite, constipation, diarrhea) among the 3 groups were observed and the Hp eradication rate and the incidence of adverse reactions (nausea, vomiting, loss of appetite, constipation, diarrhea) were compared.@*Results@#The eradication rates in the control group, the compound Lactobacillus group, and Saccharomyces boulardii Sachets group were 80.0% (32/40 cases), 85.0% (34/40 cases), and 87.5% (35/40 cases), respectively, and the difference was not statistically significant (P=0.646); the ulcer healing rate was 100.0% of 101 Hp eradicators in 3 groups, and the ulcer healing rate of 19 cases without Hp eradicated was 48.15%, and there was a significant difference between them (χ2=51.30, P<0.01). However, there was no significant difference in the total effective rate among 3 groups (P>0.05). The overall incidence of adverse reactions in Saccharomyces boulardii Sachets group (P=0.021) and the incidence of diarrhea (P=0.002) and loss of appetite (P=0.021) was lower than that in the control group, and the differences were statistically significant.There was no significant difference in the incidence of adverse reactions between the two probiotic groups (P>0.05).@*Conclusions@#Both compound Lactobacillus acidophilus tablets and Saccharomyces boulardii Sachets group can reduce the overall incidence of adverse reactions and the incidence of diarrhea and appetite declines in children′s standard Hp eradication regimen without affecting Hp eradication rate.
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Shanghai Diet and Health Survey (SDHS) was designed to prospectively access local residents' food consumption, energy and nutrient intake, related chemical contaminant exposure, and the seasonal change trend to explore the relationship of diet with health. Data from SDHS can be used as fundamental information and scientific evidences for the development of local nutrition and food safety policies.
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China , Diet , Energy Intake , Health Surveys , Nutrition Policy , Nutrition SurveysABSTRACT
Objective: To analyze dietary pattern and its seasonal characteristic in residents of Shanghai. Methods: A representative sample was surveyed and followed up in four different seasons during 2012-2014. Information of food consumption was collected by 3-day 24-hour dietary recall and condiments weighing method. The intake of energy and macronutrients were calculated according to the Chinese Food Composition Table. Results: Annual average daily intake was 191.09 g for grain, 250.69 g for vegetable, 107.23 g for fruit, 223.53 g for animal food, 96.39 g for dairy products, 11.19 g for soy bean and its product, 36.54 g for cooking oil, and 7.57 g for salt. Significant differences were observed in food consumption among different seasons (P<0.05). Annual average daily intake of energy was 2 048.70 kcal, carbohydrates was 241.04 g, protein was 82.35 g, fat was 85.99 g and proportion of energy contributed by fat was 37.99%. Different seasons, age, residential areas, and income were influence factors for food consumption (P<0.05). Conclusions: Energy intake was adequate in residents of Shanghai. Unhealthy dietary pattern, including high proportion of fat and consumption of cooking oil and salt (lower than average intake of large cities, but higher than recommendation), was observed. It is necessary to take appropriate nutrition intervention, and future researches on dietary intake should consider seasonal influences.
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Humans , China , Cities , Diet , Energy Intake , Feeding Behavior , SeasonsABSTRACT
Objective: To understand the dairy product intake in residents of Shanghai, its seasonal changes and the influencing factors. Methods: A group of representative residents was surveyed and followed up in four seasons in Shanghai during 2012-2014. Information of the dairy product intake was collected by food frequency questionnaire. Results: Liquid milk and yogurt were the main dairy products consumed by the residents of Shanghai. The annual dairy product intake rate was 41.8%, and the median of dairy intake of milk was 145.3 g/d, accounting for 48.4% of reference dietary intake value, and only 4.5% of people's diary product intake reached intake reference value. The area specific differences in intake rate of liquid milk, yogurt and total dairy product intake were significant in four seasons and in whole year (P<0.05). The area specific differences in total dairy product intake were significant (P<0.05) in spring, summer and winter. In general, it was shown that dairy product intake in urban area was higher than that in suburban area and in rural area. The data of Shanghai and urban area showed that the total dairy product intake was significant different among four seasons (P<0.05), but no significant difference was observed among four seasons in suburban and rural areas. The logistic regression analysis results showed that people with average household income higher than local average level or higher education levels were more likely to consume dairy products daily. People who reported to have good health status or sleep quality were more likely to drink milk compared to those who have worse health status or sleep quality (P<0.05). Conclusions: Even though dairy product intake rate and volume have been improved in residents in Shanghai, it is still stay at lower level, especially in rural area. To promote consumption of dairy products, it is necessary to control diary product price from macro perspective, and strengthen healthy education about the importance of dairy product intake and guide residents to select suitable dairy products.
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Animals , Humans , China , Dairy Products , Diet , Milk , Seasons , Surveys and QuestionnairesABSTRACT
Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in children.Compared with adults,NAFLD in children progresses rapidly and the prognosis is poor.A number of studies have demonstrated that intestinal flora imbalance plays an important role in the pathogenesis of NAFLD.The development of microbes in the intestinal can be traced back to the intrauterine period,and the diversity of microbes mainly occurs in childhood.At present,the exploration of drug therapy for children with NAFLD is still underway.Adjusting the intestinal flora can improve the state of oxidative stress and inflammatory injury in the liver,so as to improve the body's metabolic abnormality and delay the progression of liver disease in NAFLD patients,which has important clinical significance in preventing and treating NAFLD in children.
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Shanghai Diet and Health Survey (SDHS) was designed to prospectively access local residents' food consumption,energy and nutrient intake,related chemical contaminant exposure,and the seasonal change trend to explore the relationship of diet with health.Data from SDHS can be used as fundamental information and scientific evidences for the development of local nutrition and food safety policies.
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Objective To analyze dietary pattern and its seasonal characteristic in residents of Shanghai.Methods A representative sample was surveyed and followed up in four different seasons during 2012-2014.Information of food consumption was collected by 3-day 24-hour dietary recall and condiments weighing method.The intake of energy and macronutrients were calculated according to the Chinese Food Composition Table.Results Annual average daily intake was 191.09 g for grain,250.69 g for vegetable,107.23 g for fruit,223.53 g for animal food,96.39 g for dairy products,11.19 g for soy bean and its product,36.54 g for cooking oil,and 7.57 g for salt.Significant differences were observed in food consumption among different seasons (P<0.05).Annual average daily intake of energy was 2 048.70 kcal,carbohydrates was 241.04 g,protein was 82.35 g,fat was 85.99 g and proportion of energy contributed by fat was 37.99%.Different seasons,age,residential areas,and income were influence factors for food consumption (P<0.05).Conclusions Energy intake was adequate in residents of Shanghai.Unhealthy dietary pattem,including high proportion of fat and consumption of cooking oil and salt (lower than average intake of large cities,but higher than recommendation),was observed.It is necessary to take appropriate nutrition intervention,and future researches on dietary intake should consider seasonal influences.
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Objective To understand the dairy product intake in residents of Shanghai,its seasonal changes and the influencing factors.Methods A group of representative residents was surveyed and followed up in four seasons in Shanghai during 2012-2014.Information of the dairy product intake was collected by food frequency questionnaire.Results Liquid milk and yogurt were the main dairy products consumed by the residents of Shanghai.The annual dairy product intake rate was 41.8%,and the median of dairy intake of milk was 145.3 g/d,accounting for 48.4% of reference dietary intake value,and only 4.5% of people's diary product intake reached intake reference value.The area specific differences in intake rate of liquid milk,yogurt and total dairy product intake were significant in four seasons and in whole year (P<0.05).The area specific differences in total dairy product intake were significant (P<0.05) in spring,summer and winter.In general,it was shown that dairy product intake in urban area was higher than that in suburban area and in rural area.The data of Shanghai and urban area showed that the total dairy product intake was significant different among four seasons (P<0.05),but no significant difference was observed among four seasons in suburban and rural areas.The logistic regression analysis results showed that people with average household income higher than local average level or higher education levels were more likely to consume dairy products daily.People who reported to have good health status or sleep quality were more likely to drink milk compared to those who have worse health status or sleep quality (P<0.05).Conclusions Even though dairy product intake rate and volume have been improved in residents in Shanghai,it is still stay at lower level,especially in rural area.To promote consumption of dairy products,it is necessary to control diary product price from macro perspective,and strengthen healthy education about the importance of dairy product intake and guide residents to select suitable dairy products.
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Objective To investigate the intervention value of intensive care team in neonatal respiratory distress syndrome.Methods 110 cases of neonatal respiratory distress syndrome were selected,by using a random number table method they were randomly divided into the observation group and the control group,55 cases in each group.The control group was treated with routine care model,the observation group dedicated care team for critically ill children.The incidence of complications,mechanical ventilation time,cost of hospitalization,duration of hospitalization were compared after the care of children.Results The incidence rates of infection,abdominal bloating and intraventricular hemorrhage in the observation group (3.64%,1.82%,0.00%) were significantly lower than those in the control group(20.00%,16.36%,5.45%),the incidence of infection,abdominal distension between the two groups had statistically significant differences (χ2=4.852,P=0.027;χ2=7.040,P=0.008).The mechanical ventilation time,hospitalization time in the observation group [(11.23±2.17)d,(23.45±5.45)d]were significantly shorter than those in the control group[(16.78±4.52)d,(26.78±6.47)d],there were statistically significant differences between the two groups(t=8.209,P=0.000;t=2.919,P=0.004).The hospitalization costs of the observation group[(20 462.78±214.45) yuan] was significantly lower than the control group [(24 975.45±312.45)yuan],there was significant difference between the two groups(t=88.311,P=0.000).The total effective rate of the observation group was 98.18%,which was higher than 87.27% of the control group,there was statistically significant difference between the two groups(χ2=4.852,P=0.027).Conclusion Full implementation of critical care nursing team intervention on neonatal respiratory distress syndrome,can effectively reduce the incidence of children with complications,mortality,shorter hospital stays,reduce hospitalization costs,the effect is significant and should be introduced.